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Medicare Premium Assistance Program Coordinator

Employer
University of Massachusetts Medical School
Location
529 Main Street

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Administrative Jobs
Institutional & Business Affairs, Program Administration, Technology, Analysts & Programming
Employment Type
Full Time
Institution Type
Four-Year Institution
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Job Details

Overview

GENERAL SUMMARY OF POSITION:  

This is a benefited position that is funded through an Interagency Service Agreement (ISA) with the Executive Office of Health and Human Services (EOHHS) and the University of Massachusetts Medical School. Medicare Premium Assistance, also known as Medicare Buy-In, is a federal program that allows states to pay all or part of monthly Medicare premiums and cost sharing for eligible Medicare beneficiaries who meet income and asset guidelines.  The Medicare Premium Assistance Unit within the Medicare Eligibility Enhancement Programs at the Center for Health Care Finance Solutions administers this program for the Massachusetts Medicaid program, MassHealth. 

 

Under the general direction of the Senior Manager, the Medicare Premium Assistance Program Coordinator will assist in the coordination and management of the daily operations of the program and seek to maximize benefits available in private and public programs in order to preserve MassHealth as the payor of last resort.

Responsibilities

MAJOR RESPONSIBILITIES:

  • Identify, evaluate, and coordinate Medicare Premium Assistance benefits for MassHealth members.
  • Interact with MassHealth members, providers, families, EOHHS staff, and state and federal agencies to coordinate Medicare Premium Assistance benefits as it relates to the member’s eligibility.
  • Responsible for documenting and tracking all information associated with cases and reporting cost savings and caseload data.
  • Make appropriate referrals to various EOHHS units and federal agencies such as the Social Security Administration and the Centers for Medicare and Medicaid Services to coordinate functions as required.
  • Provide trainings to health care providers and other stakeholders on coordination of benefits with Medicare Premium Assistance.
  • Evaluate and update data information to maintain member Medicare coverage and premium payment status within the state Medicaid Management Information System (MMIS).
  • Correspond with internal and external stakeholders, including representatives of the Social Security Administration (SSA), Center for Medicare and Medicaid Services (CMS), the Railroad Retirement Board (RRB), and MassHealth Customer Service Center (CSC) and MassHealth Enrollment Centers (MECs) to provide information and resolve issues as needed.
  • Research payment transaction codes generated by SSA, CMS, and MMIS to accurately process member Medicare coverage and premium payments.
  • Provide direct customer service to MassHealth members including, but not limited to, answering, researching, and resolving inquiries in relation to Medicare coverage, eligibility and premium payments.
  • Represent the Medicare Premium Assistance Unit at member appeal hearings, as needed.
  • Investigate and resolve Medicare coverage, premium payment, and demographic exception cases.
  • Maintain, enhance and quality control existing systematic reports to capture exceptions and identify discrepancies.
  • Prepare internal reports and provide routine updates on productivity levels and status of assigned work.
  • Participate with MMIS technical team members in research and testing of change orders and Data Change Requests (DCR) to be implemented in MMIS.
  • Conduct business in accordance with approved standards and processes, including all data security and usage guidelines
  • Perform other duties as assigned
Qualifications

REQUIRED QUALIFICATIONS:

  • Bachelor’s degree in Health Care Administration, or related field, or equivalent experience
  • 4 years relevant professional experience
  • Excellent oral and written communication skills.
  • Effective time management and customer service skills.
  • Ability to interpret state and federal laws and regulations
  • Strong attention to detail
  • Demonstrated ability to handle confidential information and to exercise judgment and discretion
  • Proficient in Microsoft Word, Excel, and Access.
Additional Information

PREFERRED QUALIFICATIONS:

  • Previous insurance or benefit coordination experience
  • Knowledge of rules and regulations of the Medicare and Mass Health programs
  • Previous experience communicating professionally and effectively with public sector personnel, businesses, legal representatives, or private citizens
  • Bilingual skills

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Organization

Realize Your Opportunities – A Career at UMASS Medical School

Inside Workings at UMASS Medical School

The University of Massachusetts Medical School (UMMS), the Commonwealth's only public medical school, is proud of our role in serving the people of Massachusetts. Although, its the inside workings of UMMS that makes the difference.

Mission and Culture

  • We’re serious about our mission and about our people. 
  • Real World Impact - Our people get excited about our mission of real-world impact in health sciences education, research and public service.
  • International Prominence and New Opportunities - As this institution has grown to national – and international – prominence, we’ve found new opportunities to train tomorrow’s physicians, nurses and scientists,  discover causes of and cures for disease and help improve the quality of health care.
  • Deep Commitment - With our clinical partner, UMass Memorial Health Care, and our other teaching affiliates, we share a deep commitment to national distinction in patient care.
  • Valued Partnerships – UMMS partners with Commonwealth Medicine, the health care consulting arm of UMMS. Also, UMMS partners with MassBiologics in scientific collaborations, technology management and creating partnerships for the development of products for the benefit of patients.  These valued partnerships help us to provide services and programs to help meet our needs at UMMS and the public.
  • Proud Contributors - People at UMMS enjoy the feeling of going to work every day knowing what they do is truly important and worthwhile.
  • Complementary and Inseparable - These varied parts of our mission and culture are complementary and inseparable.                 

Careers

UMMS, the state’s first and only public academic health sciences center, educates physicians, scientists and advanced practice nurses to heal, discover, teach and care, with compassion.  UMMS is a world-class institution with opportunities to match. 

Competitive Compensation – UMMS offers salaries that are competitive with Worcester-area employers. When combined with our generous benefits, perks, and paid time off, many job seekers are surprised to find a total rewards package that matches or exceeds their current situation.

Targeted Hiring Process – At UMMS, there are actually multiple hiring processes for different segments of our workforce.  In nearly all cases, UMMS hiring process is decentralized, with qualified candidates screened and referred to an academic officer or manager with hiring authority.

24/7 Access to Employment Opportunities – iCIMS is our online job search and application system.  iCIMS is available 24/7 to provide you with a convenient and up-to-date view of the available employment opportunities across our campuses. Updates are made daily and include all faculty and non-faculty position listings from every school and department within the UMMS. When you identify a position you are interested in and qualified for, apply online. New opportunities become available frequently so it pays to check back often!

Benefits

With outstanding benefits, competitive pay, extensive learning opportunities, and a stimulating and attractive work environment, UMMS may be exactly the employer you’ve been looking for.

• Superior Benefits - UMMS offers a wide range of benefits and perks that invite comparison with the best employers in the Worcester area – and with academic institutions anywhere. UMMS provides superior medical and dental coverage for you and your family, fully funded retirement plans, generous time off, a Tuition Assistance Plan – and much more.

• People Centered - UMMS is an employer, but it is also a community. Its comprehensive medical and dental benefits, retirement plans, and even paid holidays reflect an institution built around people, with a deep respect for their differences and needs.

• Commitment to Healthy Living - UMMS provides resources to help you balance work and life and encourages healthy living through great programs and discounts for fitness, physical activity, weight management, nutritional counseling and general wellness available through our health insurance plans.

• Breadth of Offerings - Above all, the breadth of UMMS offerings set the School apart and makes it an environment favored by all sorts of smart, career-savvy people.

Apply for a Job

As an equal opportunity and affirmative action employer, UMMS recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds.

Online - To view all job opportunities and apply online, visit www.umassmed.edu/hr and click on the “Careers” tab.

Start Now and Realize Your Opportunities!

A History of Making Vital Improvements - UMASS Medical School Milestones

1962: Legislation establishes University of Massachusetts Medical School
1970: First medical students begin classes in Shaw Building
1974: First class graduates 16 MDs
1979: PhD program begins
1986: Graduate School of Nursing opens
1986: PhD program becomes Graduate School of Biomedical Sciences
1994: Graduate School of Nursing initiates PhD program
1998: UMass Clinical System and Memorial Health Care merge to form UMass Memorial Health Care
2001: Lazare Research Building opens
2002: Campus Modernization begins on the University Campus
2004: Graduate Entry Pathway Program established at the Graduate School of Nursing
2005: PhD Program in Clinical & Population Health Research established at the Graduate School of Biomedical Sciences
2005: Massachusetts Biologic Laboratories opens new manufacturing and filling facility in Mattapan
2006: Craig Mello, PhD, Blais University Chair in Molecular Medicine and Howard Hughes Medical Institute Investigator, is awarded the Medical School's first Nobel Prize. Dr. Mello shared the 2006 Nobel Prize in Physiology or Medicine with Andrew Fire, PhD, of Stanford University, for their discoveries related to RNA interference.
2007: Michael F. Collins, MD, is named chancellor and Terence R. Flotte, MD, is named dean of the School of Medicine.  
2009: Groundbreaking for the Albert Sherman Center, a 500,000-square-foot research and education facility slated for completion in 2012.
2010: Ambulatory Care Center opens
2012: The Albert Sherman Center, a 500,000-square-foot research and education facility, completed and opens

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